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Palpatine had a recording device and a camera in his office. Shortly before the duel, Palpaine disabled to the camera, but enabled the recording. This is what the recording heard.PALPATINE: Why, Master Windu. What a pleasant surprise.MACE WINDU: Hardly a surprise, Chancellor. And it will be pleasant for neither of us.PALPATINE: I'm sorry? Master Fisto, hello. Master Kolar, greetings. I trust you are well. Master Tiin—I see your horn has regrown; I'm very glad. What brings four Jedi Masters to my office at this hour?MACE WINDU: We know who you are. What you are. We are here to take you into custody.PALPATINE: I beg your pardon? What I am? When last I checked, I was Supreme Chancellor of the Republic you are sworn to serve. I hope I misunderstand what you mean by custody, Master Windu. It smacks of treason.MACE WINDU: You're under arrest.PALPATINE: Really, Master Windu, you cannot be serious. On what charge?MACE WINDU: You're a Sith Lord!PALPATINE: Am I? Even if true, that's hardly a crime. My philosophical outlook is a personal matter. In fact—the last time I read the Constitution, anyway—we have very strict laws against this type of persecution. So I ask you again: what is my alleged crime? How do you expect to justify your mutiny before the Senate? Or do you intend to arrest the Senate as well?MACE WINDU: We're not here to argue with you.PALPATINE: No, you're here to imprison me without trial. Without even the pretense of legality. So this is the plan, at last: the Jedi are taking over the Republic.MACE WINDU: Come with us. Now.PALPATINE: I shall do no such thing. If you intend to murder me, you can do so right here.MACE WINDU: Don't try to resist.[sounds that have been identified by frequency resonances to be the ignition of several lightsabers]PALPATINE: Resist? How could I possibly resist? This is murder, you Jedi traitors! How can I be any threat to you? Master Tiin—you're the telepath. What am I thinking right now?[sounds of scuffle]KIT FISTO: Saesee—AGEN KOLAR: [garbled; possibly "It doesn't hurt"(?)][sounds of scuffle]PALPATINE: Help! Help! Security—someone!Help me! Murder! Treason![recording ends]Of course, the end of the recording was when Palpatine turned it off, but he claimed the Jedi turned it off.Palpatine showed this recording to the public, and claimed that clone troopers rescued him. That’s how he explained the Jedi Rebellion.Stay safe,-Ben

Wanted to share that I’m going through a similar thing with my brother who I love dearly. My younger brother and I, who are close, both applied to university at the same time. We were accepted into the same university. He ended up choosing not to enroll and to instead move-in with a girl he met on Tinder last year.Since meeting this girl, my brother displayed remarkably different attitudes towards me. Whereas before he was very friendly and warm, he became distant, critical and rude. These qualities were very unlike him and it soon became obvious he had changed due to his exposure to his girlfriend.The girlfriend’s situation seemed troubled and negative from the start. She’s around 30 years old, he’s in his early-mid twenties. She was in the process of divorce, yet was still living with her husband. She dated my brother for over six months while still living with her husband, or ex-husband. I found this to be bizarre, but he apparently thought nothing of it.My brother described several disturbing characteristics of hers, of which I won’t go into detail. Suffice to say she had a rough background, substance abuse issues, and apparent emotional disturbance. Apparently my brother recognized none of these problems (that he openly disclosed to me) as red flags.Our relationship became strained when it became apparent he was forgoing his university transfer, because it was so clear he was making a HUGE mistake. I tried to propose scenarios in which he could live with me and attend school while splitting time by driving the approx one hour distance to his girlfriend's place.She had her claws sunk so deeply into him that he wouldn’t even consider such a compromise. I pleaded with him to at least visit campus but he wouldn’t do any due-diligence…keep in mind he applied to university before meeting her and she somehow convinced him not to attend after he was accepted.So eventually he moved out and I moved in with my girlfriend 90 miles away to attend university. My brother helped me move, and during that time I found out his girlfriend had been speaking negatively about me for several weeks. I won't go into detail about her petty grievances against me, because they're a mixture of shameful lies and exaggerated nonsense. Her initial complaints against me were petty by definition but the response is not reasonable, proportionate or normal.Instead of approaching me directly about her concerns, she proceeded to talk shit about me to my brother for over two months, which greatly disturbed him. She cultivated an extremely negative image of me that is nowhere near representative of who I am as a person.She threw a fit because my brother was staying the first night with us (which we planned weeks in advance) and he ended up breaking down in tears over her emotional abuse. He left that night to return to her, breaking his word to me because she harassed him so much. I am permanently disabled and needed my brother’s help during my move, but apparently his girlfriend was very angry at my brother for helping me, binge drinking and being verbally abusive to him before he left. She also harassed and pressured him to ditch us over text message, texting him non-stop for literally 5–6 hours the entire time he was helping us.My working theory is that she perceives me as a threat because she knew my brother was conflicted about moving in with her due to my influence. She's a domineering and controlling woman, and I can tell she plays my brother like a fiddle, constantly manipulating his emotions. (he is quite naive).As a result, she has created so much negativity between myself, her, my brother and my partner. She threw a tantrum that I unfriended her on facebook (this woman is 30 years old, older than both my brother and myself) and sent me a vile message making false accusations about me and threatening to make the situation worse --- she demanded I apologize to her for things that never happened....it's completely insane.I don't back down to liars and toxic manipulators (never have, never will) so I called her out on her childish attempts to create drama and told her to stop lying about me. She because extremely angry, refused to speak with me further. At that point I realized she essentially laid a trap for me, and any response other than a submissive apology would be a huge win for her...because she used what I said in response to manipulate my brother further.My brother now claims he's hurt that I didn't apologize to her and make the situation better. In hindsight, perhaps I should have just played along with her insanity to keep the peace....but that's not who I am. Especially not when someone's lying about me, and emotionally abusing someone I love dearly.And what kind of example would that set for my younger brother? That you should allow your partner to attack your family without merit? That you should back down and submit to toxic behavior?I've already warned my brother that her instability will manifest itself in a new way once she's forgotten about me.I love my brother so much and it hurts me so deeply that he's jeopardizing his future with this toxic person. I don't know why she hates me so much or why she's so obsessed with vilifying me, but I can only assume it's part of her mission to control and dominate my younger brother.One of the saddest and most helpless feelings I've ever felt. It feels like an anchor of grief and misery that I wear at all times.UPDATE: According to Quora, over 20,000 people have viewed and continue to view this answer I wrote 8 months ago. I wanted to update and include new perspective/advice for anyone going through a similar situation.Regrettably, the situation described above has not improved. But perhaps you can learn from my mistakes and errors in judgment to avoid worsening any similar conflicts in your life. I maintain that my brother’s girlfriend’s toxic behavior is the root cause of this entire situation, but I still have enough humility and capacity for self-reflection to admit where I messed up. Sadly, she does not share a similar capacity for humility and self-reflection.Since the fall of 2018, I have made repeated attempts to resolve the conflict offline and in person. It goes without saying serious interpersonal conflict should never be dealt with over social media, even if someone else provokes you over social media. That’s my primary piece of advice. Almost a year since my brother’s girlfriend sent me that harassing and threatening message on Facebook, she has refused to meet with me. I doubt she will ever muster the courage or confidence to meet with me, and that’s frustrating. But it proves she does not have the confidence to stand behind her lies, drama, and toxic behavior, which reveals a lot.All this to say that my brother and I have not been kind to one another. I have not seen him this year. I don’t know if we will ever be friends again. In my attempts to get through to him, my frustration and a genuine sense of betrayal gave way to bitter words, accusations, and judgments. There’s no doubt my brother has behaved awfully towards me, and I let him know all about it. And for that, I don’t blame him for feeling estranged or hurt. I do take responsibility for my harsh words, but also recognize my brother’s abusive relationship and his girlfriend’s refusal to resolve intensified these conditions.What’s especially frustrating is she knowingly disregarded my personal boundaries when confronting me in the first place, but the double standard dictates I must respect her personal boundaries about not wanting to meet and resolve the conflict. And that’s understandable. Nobody should ever be forced into having a conversation they don’t want to have. But why doesn’t that apply both ways? Why was I forced into a confrontation with her after I explicitly told my brother I didn’t want to be apart of any drama and she knew it? Because she is so controlling that she manipulates every aspect of the conflict, and is able to control and influence my brother’s thoughts and actions to the extent that he is essentially brainwashed.Her refusal to meet with me and settle the matter more or less confirms this. If you’re going to act reckless and use social media to attack someone when you’re having a meltdown, you should at least have some dignity to later pull yourself together, act like an adult, take responsibility for your shitty actions, and face the person in real life. Show some humanity. Personally…anything I say on the internet I’m willing to back up in real life, but for my brother’s abusive girlfriend Nicky Shepard, that isn’t the case. She feels more comfortable talking shit behind people's back like a teenager and threatening a disabled man over the internet with a creepy 8-paragraph long rant over Facebook Messager. But you wouldn’t believe the desperate lengths my brother has gone to defend, make excuses for, and prop-up Nicky’s cowardly act of bullying and emotional violence carried out on social media. So I guess my brother isn’t the life long friend or loyal person I thought he was.This situation has brought a lot of grief into my life. It still hurts me every day. I am currently on anti-depressants and in ongoing therapy to try and deal with the wreckage. Therapy has taught me that I need to let go of my brother and accept his choices as an adult. I have also reckoned with the fact that my feelings of concern and worry for my brother may be unhealthy rather than righteous or well-intentioned. I don’t think there’s an expiration date on caring for a younger sibling, but in terms of self-preservation, I need to detach myself from caring so much. I believe I was traumatized by my brother’s descriptions of his girlfriend’s binge drinking and emotional abuse, and I cannot help but feel constantly worried about him despite knowing I shouldn’t expend the energy. I know she is a negative influence on him and a sketchy, unsafe person overall.If you’re reading this and going through a similar thing…my recommendation? Do everything you can to help your sibling but for the love of god…save yourself. Here’s a metaphor: If you love someone who’s drowning, fight like hell to save them, but don’t let them drag you down into the water. Forget about the evil girlfriend for a second. My brother’s own bad judgment and shameful behavior has worsened my life and made it more difficult…he is dragging me down. I am not a perfect person and I have made mistakes, but I don’t deserve this. I want to live and thrive and be successful and happy…I don’t want to be like him and his girlfriend who are drowning in misery, deception, lies, and abuse.So…save yourself. Don’t love someone so much that their bad decisions drag you down. Focus on your positive relationships, cultivate your personal strengths and resilience strategies. Be the love you want and enact it into the world. Never let toxic people or traitor siblings be the measure of your self-worth or self-respect. Rise above and love, and be loved, and pull yourself from the water.

EDIT (8/17/2017): Updated to include the short version of what to do for those who don’t want to read the longer version. Short version at the top, long version below it.Pretty much everything that is common knowledge about snakebite first aid is either completely ineffective or potentially dangerous. The only definitive treatment for a serious snake envenomation is the appropriate antivenom, but here is some specific advice on what to do in the field so you can make it to the hospital alive and receive antivenom. I wrote a very long post to answer this question but I am afraid that it may dissuade the casual reader, so I am including the sparknotes version here. Read the rest of the post if you want the detailed version.—————————————————————————————————————The Short VersionDO NOT make a tourniquet, cut and suck, apply the sawyer extractor or other commercial “snakebite kits”, electrocute yourself, or follow any strange recommendations you receive from other hikers on the trail.1) Carefully walk backwards and find a safe space to sit down nearby before the venom drops your blood pressure and you pass out and hit your head.2) Remove any rings, watches, bracelets, and anything else that could become a tourniquet if your limb swells up like a balloon.3) Circle the site of the bite with sharpie and write the time next to it. Mark the edge of the swelling, make a list of your symptoms, and repeat every 30 minutes or so. Always record the time.4a) If you are positive that you have been bitten by a neurotoxic snake, apply a pressure-immobilization bandage but DO NOT USE THIS FOR VIPER BITES! Once it is on you can't take it off and it will slow your ability to walk out so choose wisely.4b) If you begin to experience signs of anaphylaxis (swelling of face, mouth, or throat; hives; difficulty breathing, etc) use an epi-pen if you have one and then take Benadryl and Zantac. If you don't carry these things in the backcountry you should do yourself a favor and get them because you can't macgyver an epi-pen out of nothing. A lot of things can cause anaphylaxis and epi-pens can also be used as a last-ditch intervention for severe asthma attacks.5) If you have cell phone reception call 911, tell them where you are, when you were bitten, and the list of current symptoms you just wrote down.6) If you don't have reception, plot the safest and most expedient path to find it or reach a vehicle (whatever is safer/faster) and then start hiking out.Time is tissue and it may be better to walk yourself out in an hour than to sit on your butt for 5 hours until a helicopter can show up. I think the idea that one should do everything possible to avoid speeding up circulation of venom is bad advice. You are already terrified from being bitten by a snake so your heart rate and blood pressure are already sky high. I've treated lots of bites in remote places and pretty much all of them had to hike out to reach the hospital. Figure out the fastest, safest route to find help and then make it happen.For more information about how to treat anaphylaxis in the backcountry see my blog post on the subject here: How to treat severe allergic reactions and anaphylaxis in the backcountry (and a trick to squeeze a few extra doses out of your epi-pen)Read on below for the long version of how to survive a snakebite in the backcountry…—————————————————————————————————————The Long VersionHello Quora,My name is Jordan Benjamin and I wrote this question (and answer) in order to provide the public with accurate information about how to survive a snakebite when medical care is a long way away. There is a great deal of inaccurate and often dangerous advice floating around on the internet about snakebite treatments. I hope to shed some light on the issue today and walk you through what should and should not be done following a snakebite. In case you are wondering why you should listen to me, here is a little bit of background about who I am and what I do for a living…I am a herpetologist specializing in venomous snakes/snakebite medicine and a wilderness medicine professional with experience treating many critically ill snakebite patients in West and East Africa, most of them in remote health centers or villages that pose some of the same challenges as treatment of a snakebite in the wilderness or backcountry environment in the US (supplies are limited or non-existent, the patient has a long way to go to reach a hospital, etc). I have also been fortunate to have the opportunity to train a number of individuals and groups in snakebite medicine and field management of snake envenomations in remote conditions including medical officers and enlisted medics with US and allied military conventional and special operations units, local & international doctors and nurses in African hospitals, wildlife rangers, etc. I am including my background and real name because this issue is important to me and I stand by everything I am about to write; I want to give you all the peace of mind that I am who I say I am and not someone throwing out inaccurate information behind the cloak of online anonymity. Feel free to look me up online, I gave a TEDx talk on the issue of snakebite in sub-Saharan Africa back in 2013 and I invite those who doubt my identity or simply want to learn more about the issue of snakebite in the developing world to check it out: Solving snakebite in Sub-Saharan Africa: Jordan Benjamin at TEDxWhitmanCollegeTreating a man for a carpet viper (Echis ocellatus) envenomation in West Africa……and here is a photo of the carpet viper that bit him.Moving on to the meat and potatoes of this post…Let’s begin with what you should not do in the case of a snakebite, because not making it worse is actually one of the best ways to improve your odds of keeping life and limb following a severe snakebite.What you should not do: Out of the dozens of snakebite patients I have personally treated in sub-Saharan Africa, over 95% of them had already been given bad first aid prior to seeking treatment at the hospital. Practices like cutting at or around the site of the bite, applying tourniquets to the bitten limb, and attempting to extract or neutralize venom using electricity, fire, permanganate, black stones, magic, mouths, mud, dung, leaves, ground up dried snakes, and yes - even fancy suction devices like the Sawyer Extractor - are dangerous and detrimental for two reasons:First, in a snakebite time is tissue and a lot of it is wasted performing bad first aid. Many snakebite patients injure themselves by panicking immediately after the bite, I have seen more than a few individuals who suffered serious traumatic injuries in addition to the snakebite because they took off running from the snake at full speed only to suddenly fall face-first onto a rock or trip and stumble over the edge of a steep embankment.Signs of an envenomation may in some cases take hours to appear, and the combination of seeing a useless suction device drawing fluid out of the bite along with a delayed onset of symptoms is an easy way to decide that you don't need medical care after all because you the used extractor less than minute after the bite and saw it remove the venom, or you feel fine and don't want to inconvenience the whole group because you've all been planning this trip for months, or any number of other rationalizations we can make with ourselves to keep from going in to get the bite checked out. The majority of bites from venomous snakes in the United States are suffered by young men between the ages of 18 - 25 who are intoxicated (usually alcohol) and attempting to pick up, kill, or otherwise interact very closely with a potentially deadly snake. This is a demographic that is particularly prone to making the wrong decision about whether they should laugh it off cause they feel okay or should immediately seek medical care for a life-threatening emergency.The photo below shows the Sawyer Extractor, widely sold at outdoor stores such as REI and Cabelas as “the only suction device proven to remove snake venom”. The Sawyer Extractor is very bad for snakebites! It is useless for any type of envenomation and should be pulled from the market for fraudulently claiming that it removes clinically significant amounts of venom, which it does not. Sawyer Extractors have only been shown to increase local tissue destruction at the site of application without preventing, reducing, delaying, or otherwise doing anything useful to hinder the systemic effects of a serious snake envenomation. The most generous thing I can say about the Sawyer Extractor is that it is totally useless for envenomations, the more honest one is that it ranges from totally useless to potentially harmful.I have had patients come early after the bite and I have had patients come after great delays, and I have noticed two things. The first is that those who arrive early often do so because they are suffering from a severe envenomation and become very ill very quickly, while those who come late often waited because they believed falsely that the first aid measures taken were sufficient or that they were not seriously envenomated. The second observation is that many of the patients who wait come in when they finally reach their own line in the sand for what constitutes a serious enough problem to go to the hospital. This group of patients tends to have more complications, longer hospitalizations, and a higher chance that the bite will result in permanent disability because of how long the venom has been allowed to work unchecked. They often arrive in critical condition with serious envenomations just like the other group of severely envenomated patients with the shortest delay to care, but instead of showing up in a critical state of hemorrhagic or hypovolemic shock they arrive in shock with their kidneys failing, or with late-stage bleeding into the brain, meninges, abdominal cavity to compound all of the other symptoms. Late-stage complications can be incredibly difficult to treat, they are excruciatingly painful for patients, heart-wrenching cases for medical personnel, and they are entirely preventable with prompt care. This patient applied a tourniquet to his leg after a puff adder bite and relied on the witchdoctor for an herbal remedy instead of coming to the hospital for antivenom treatment. By the time he arrived at a hospital the combination of extensive damage from the untreated venom and raging infection from the witchdoctor’s inappropriate “treatment” had left him in a very bad state. He was fortunate to survive, but sadly lost his lower leg. He would have most likely made a full recovery and been discharged within 3 days if he had come to the clinic first.If you are bitten by venomous snake or are unsure as to whether or not the snake is venomous, please, please, please focus on how to get yourself safely to emergency medical care and don't bet your life on any commercial snakebite kits, witch doctors, or homeopathic remedies. Your aunt Edna may know how to treat a stomach ache or burn off a wart but unless she also happens to have successfully treated a hell of a lot of snakebites in the field I would suggest you ignore her advice on this one. The only effective, definitive treatment for a snake envenomation is the appropriate antivenom to neutralize the venom of the species you were just bit by. I repeat, THE ONLY EFFECTIVE TREATMENT FOR SNAKE ENVENOMATION IS THE APPROPRIATE ANTIVENOM. Repeat that five times and them move on to some helpful tips on what you actually should do in the event of a snakebite in the middle of nowhere.What you should do: There are several things I would suggest you do following a snakebite that are extremely beneficial.Walk, don't run, and carefully retrace your steps to get out of the immediate vicinity of the snake and avoid the possibility of stepping on any others nearby. About 20 or 30 feet should be more than sufficient, the snake wants to get away as much as you do.Find a safe place to sit down. This is important! Viper venoms in particular contain vasodilating compounds that open up your blood vessels to facilitate rapid diffusion of venom out into systemic circulation, which means you may suddenly suffer a dizzy spell and faint because your blood pressure just dropped too low to pump all the way to your head while you are standing upright. This is relatively common with viper bites and often happens in the first few minutes, so do yourself a favor and sit down so you don't pass out while running and hit your head on a rock. Like I said, you would be surprised...it happens all the time. These are usually brief fainting spells and you stand a good chance of avoiding it altogether by not standing up in a state of abject terror, but if you faint it shouldn't be more than a few minutes before you are cognizant again and I guess if you want to look at the bright side, you just really nailed the whole relaxation part of step 3 and are sort of ahead of the game...but you should repeat step 3 now that you are conscious anyways. Treat anaphylaxis if it occurs at any time (see Epinephrine Autoinjector and Antihistamines further down in this post).Remove any rings, watches, bangles, anklets, tight clothing, and anything else from the bitten limb because there is a good chance it is going to get a whole lot bigger than it was when you bought that toe ring. Do this because any of these items could potential become a tourniquet when swelling makes them impossible to remove, and that could cost you the limb below whatever is choking off the supply of oxygenated blood. Tourniquets of any sort are not good for snakebite, so please don’t try to tie your shoelaces or belt or anything else above whatever part of you just got bitten. There are somewhere between 5,000 - and 10,000 snake envenomations in the US every year, but most will not suffer any major permanent disability and on average only 5 people will die in a given year (mostly very old, very young, highly allergic, and other high-risk populations). At any rate, in the United States in particular your odds of recovering from a rattlesnake bite are quite good due to antivenom availability. Be grateful you live in the US and make sure you don’t become a (bad) statistic by doing something stupid that makes your situation a whole lot worse than it was already.Now that you are sitting, take at least 5 minutes to calm down and put your mind to a productive task: planning your evacuation. Time to break out the two items that I highly recommend for a snakebite kit that will help you save your own hide.Mobile phone: Do you have a cell phone? Does it have service here? If not, where did it last have a connection? Since the only definitive treatment for a snake envenomation is the right antivenom to neutralize it, a working cell phone is your best means of getting information out to the emergency personnel who will do everything in their power to bring you safely out of the field and into the best medical facility for your current predicament. If you can call right away, those 5 minutes you took to calm down are going to prove helpful in relaying key information such as who you are, where you are, what happened, how you are feeling, as well as pertinent information like any other coexisting medical conditions and medications you currently take. If you take any sort of anticoagulants (so-called “blood thinners”) then that is definitely something you want to inform them of right away, and please folks - do not take aspirin, ibuprofen, or any other NSAIDS after a snakebite. All of these medicines interfere with blood clotting, and they can cause very nasty problems for snakebite patients by increasing the severity of any internal or external bleeding that may occur. Tylenol (acetaminophen) is okay, take up to 2x 500mg tablets if you feel the need as it won't interact with the snakebite in any way but don't forget to write down and inform the medics of everything you have taken when they get there to avoid being double-dosed.Permanent marker: The second item I cannot speak highly enough of for snakebites is a Sharpie or similar permanent marker. If you are indeed envenomated, your primary objective right now is to get to the antivenom and get the treatment going so it can do its job. From a clinical standpoint, there are several things you can keep track of in the prehospital environment that will prove immensely beneficial when you reach the hospital and we begin assessing the severity of your snakebite to figure out if you need antivenom, how much you need right now if you do, and what other effects the venom is causing so we can treat them with other medications and/or interventions. Here's how this works. You are going to assess yourself from top to bottom and document significant findings on your person along with the time that you are observing it. Notes can get lost during evacuation or rescue, but your leg is coming with you to the hospital whether you like or not so get ready to mark it up. First thing to do is circle the site of the snakebite with the sharpie and write the time of bite next to it. Draw a circle around the border of the swelling, or if the bite is on a finger or toe then draw a line at the edge of the swelling as it moves up the limb, and once again: write down the time with each reassessment and subsequent marking. This is a picture of me charting the progression of swelling and persistence of bleeding in a patient 3 hours after his first dose of antivenom.Write down all of the symptoms that you are experiencing right now that are not normal for you next to or within the circle you just drew, and make sure it’s clear what time you are writing them at. These may include (but are not limited to):metallic taste in your mouthchanges to sense of smellsudden loss of vision, double vision, visual disturbancesringing in the earsheadachenausea and vomiting abnormal persistent bleeding from the bite wound or anywhere elsedizzinessshortness of breathtremors, twitching, or cramping that moves up the bitten limbpain, numbness, tingling, burning, electric shocks, and all manner of unusual sensationsloss of bowel or bladder controlexcessive secretion of saliva/tears/snot/sweatdroopy eyelids that get progressively harder to open (ptosis)can’t stick out your tongue at your friends like you could a few minutes earliercan’t shrug your shouldersstrong feelings of impending doom or anything else we might want to know aboutRun down the list of your five senses and record anything unusual - big or small - that jumps out at you. If you suddenly find that you have developed a sixth sense you might as well write that down, too. You are creating a timeline charting the progression of signs and symptoms as they occur and providing the critical information we need as clinicians to figure out how serious of a bite you are facing and what steps need to be taken to stay on top of a developing situation. The importance of doing this cannot be overstated, and it is something that you should continually reassess and update every 15 - 30 minutes as the swelling moves up the limb and your symptoms develop. The speed at which the symptoms progress correlates with the severity of the envenomation, which is in turn helpful in determining the proper dose of antivenom to treat it. In the picture below, I administered a second dose of antivenom at 1325 and the swelling stopped just below the wrist shortly after. See how this becomes useful?Here is a crappy drawing I made at the time that illustrates the same thing.The other great thing about charting the progression of signs and symptoms is that it gives you something to focus on that will play a large part in saving your life and limb, and having a task really does help you to stay calm and get things done. The first few minutes are going to play a large part in how this whole thing turns out, so stay calm and put on your thinking cap.Q: Should you sit still until help comes or hike out on your own?Try to make contact via cell phone if it is easily doable, calm down, and carefully assess/document what you find. If you cannot get in touch with anyone then you need to think about where you are, how you got there, and what options you have to either get yourself to help or get help to you. I have had patients who walked miles out of the bush after serious snakebites to their legs, they did not die from exerting themselves and increasing circulation like many people fear will happen and they all survived because they made it out to medical care. Most of those patients were bitten by species that can produce much more complicated envenomations than our North American rattlesnakes. If you can arrange for emergency services to come and pick you up then that’s great. If you are on your own you will be much better off walking yourself out, slowly, via the same way you came in than sitting around waiting for help if you are unable to reach anyone and no one knows of your predicament. Plan the easiest, most well-travelled route back to civilization, take stock of your supplies and get some food and water in you so you don’t pass out on the way from something preventable like dehydration, watch your footing and move slow and steady to your target destination. Don’t go around doing jumping jacks, but remember that it is better to get to the antivenom sooner rather than later. Do what it takes to get there alive and in one piece without taking any stupid risks.Q: What should you pack in the event of a snakebite?This is a jump kit I made and carried around in Africa for treating bites in remote villages. It has just about everything needed to provide definitive care at the advanced life support provider level to serious snakebite patients in the field (there are a few other items not pictured as well). The good news is you don’t need to worry about all of this stuff! Keep reading to find out why…In addition to the cell phone and permanent marker, there are two other items I highly recommend for inclusion in a snakebite kit for non-medical personnel. Both of these items are included to deal with the two worst-case scenarios that can kill you very quickly after a snakebite. The first is an epinephrine autoinjector and several doses of over-the-counter antihistamines (diphenhydramine and ranitidine, aka Benadryl and Zantac) to treat a severe allergic reaction to the snake venom known as anaphylaxis. The second is a high compression elastic bandage for restricting the circulation of neurotoxic venoms. If used inappropriately they may cause further harm, but if used correctly they are absolutely lifesaving interventions. Please read carefully and make sure you have a solid understanding of when, why, and how to use these tools. If you don’t feel comfortable with the when, why, and how of administering these treatments then you should not be using them.Epinephrine autoinjector and antihistamines (Benadryl and Zantac): The fastest possible killer resulting from a snakebite is a severe allergic reaction known as anaphylactic shock (anaphylaxis). Some people have hypersensitivities to snake venom regardless of whether or not they have suffered a previous envenomation, and these individuals can experience the same life-threating allergic reaction that is often seen after bee stings or peanut exposure. A severe allergic reaction to a snakebite will kill much faster than the venom, potentially in just a few minutes if prompt treatment is not administered. You are probably dealing with anaphylaxis if you see skin signs (itching, hives, swollen puffy eyelids, etc) AND either respiratory difficulty, gastrointestinal symptoms, or a serious drop in blood pressure appear shortly after a snakebite. As you may remember, many snake venoms cause your blood vessels to dilate and produce the same sudden drop in blood pressure that can occur with anaphylaxis. Some patients have also reported experiencing nausea and vomiting immediately after severe snakebites. So how do you know when to treat? It’s fairly simple: if you are dealing with only blood pressure effects (such as dizziness, fainting, etc) or only nausea/vomiting without the other signs and symptoms then it is likely to be a direct effect of the venom and you can probably hold off on administering the epi-pen and antihistamines unless the situation changes. But if there is any sort of rapid swelling of the face/lips/tongue/throat, onset of wheezing or shortness of breath, appearance of hives then it is appropriate to treat for anaphylaxis. Any sort of airway compromise is reason enough to treat for anaphylaxis regardless of whether the other signs/symptoms are present. The recommended antihistamines for this situation would be Benadryl (diphenhydramine) and Zantac (raniditine) as they cover different receptors involved in anaphylaxis, but Benadryl is the most important if you only have one. Give the epinephrine first, and then give the oral antihistamines once the patient can breath and speak clearly again. You don’t want them to choke on a sip of water and a pill if their throat is swollen up from the reaction! If you want to learn more about anaphylaxis and how to manage it in the backcountry, read my blog post about it here: How to treat severe allergic reactions and anaphylaxis in the backcountry (and a trick to squeeze a few extra doses out of your epi-pen)High compression bandage for neurotoxic envenomations: In the world of snakebite medicine, there are several different general types of envenomations that correspond to variations in venom composition between different types of snakes. Generally speaking, vipers (snakes from the family Viperidae) venoms primarily destroy the soft tissues such as skin, muscle, blood vessels, fascia, fat, etc or attack the blood and disrupt its ability to correctly regulate clotting. These venoms are therefore often described as myotoxins, cytotoxins, and hemotoxins. The other major family of venomous snakes is Elapidae and includes the cobras, mambas, coral snakes, kraits, sea snakes, and every venomous snake species in Australia (seriously). Elapid venom is composed of potent neurotoxins that disrupt the transmission of vital neurotransmitters or simply destroy the nerve terminal completely, and these venoms produce a distinctly different type of envenomation marked by a descending neuromuscular paralysis that starts at the top of the head and moves downward until it hits the diaphragm. At this point, the patient is no longer able to breath independently and will die without prompt airway management and critical care interventions. This can take anywhere from minutes to hours. The earliest death I know of due to this syndrome came 20 minutes after the bite of a forest cobra in West Africa. I also know of an individual who took nearly 24 hours to become symptomatic due to injection of venom directly into the scar tissue of an old wound on his leg. There are vipers that can cause neurotoxic syndromes and vice versa, but that is a much longer discussion for a different article and they are the exceptions, not the rules.The good news is that you are not completely out of options if bitten by a neurotoxic snake. A very large body of research has demonstrated that if applied correctly, the pressure – immobilization technique can delay the spread of venom for upwards of 12 hours. Basically, you take an elastic bandage and wrap it tight enough to restrict the lymphatic circulation without cutting off all blood circulation like a tourniquet. This is effective because the neurotoxin molecules in the venom are much smaller than the enzymes found in viper venom. They are so small, in fact, that they circulate primarily in the lymphatic system and deep tissue and not in the blood vessels like viper venoms, so there is no need to restrict blood flow in order to prevent venom from spreading out of the bitten limb. Starting at the far end of the limb (hand or foot), wrap all the way up to the armpit or thigh, then wrap all the way back down again (or as far back down as you can get it) and finally splint the limb to prevent it from bending and loosening up the bandage. Here is a video from the Australian Venom Research Unit illustrating the technique: Pressure Immobilisation Bandaging. A few key points to remember:The bandage must be wrapped at a pressure of 40 PSI to successfully restrict neurotoxic venom circulation. Conveniently, this happens to be the pressure produced when you stretch an elastic bandage as far as possible on each pass. So basically wrap it as tight as you can from below the bite site up to the base of the limb and then back down again, then splint it in place and figure out how to get out.Don’t forget to write the time of application.Once this bandage is in place, it cannot be removed until the patient has reached a hospital with antivenom at the ready and a resuscitation team in place. Removal of the bandage can cause the venom to surge into the systemic circulation, and you do not want this happening until a team of medical professionals is ready to deal with the consequences. This is extremely important!Don’t do this for your typical viper bites – you are going after the wrong circulation system but will succeed in concentrating some quantity of tissue-destructive venom inside the limb where it will cause far more damage than it would have otherwise.The only viper bite situation where this may be appropriate is one in which the patient rapidly develops obviously neurotoxic signs and symptoms, such as droopy heaving eyelids, descending paralysis, slurred speech, etc. Use this with discretion!My personal recommendation for this purpose is the Setopress high compression bandage which you can find here: http://www.amazon.com/Molnlycke-...Final thoughts: Remember, the basic principles are pretty simple. Stay calm or get calm, find a place to get yourself together and check your resources, remove constricting bands, document the envenomation, hydrate and nourish, contact help, or make a careful plan to make contact one way or another and get out the word that you need medical assistance. Don’t let fears of “raising your heart rate and increasing the speed of venom circulation” prevent you from physically moving to get to care. From what I have seen, the venom is going to get out into circulation regardless of whether or not you sit still for 24 hours or haul ass back to civilization. If you apply a tourniquet you may manage to prevent the venom from traveling out into circulation, but that would be a big mistake to make because you face a very high chance of losing your limb. Don’t put a tourniquet on and unless you fall into one of the high-risk categories discussed earlier, there is a very good chance that you will recover completely following prompt and appropriate treatment at a hospital. And remember folks, when it comes to snakebite no first aid is a whole lot better than bad first aid in the long run! Tell the boy scout to put away the pocketknife, don’t kill your own limb with a tourniquet, don’t listen to the weird fellow you pass on the trail who enthusiastically offers to suck the venom out with his mouth or pee on the wound because it saved his friend all those years back. And if you have a Sawyer Extractor or any of the other varieties of commercial snakebite first aid kits, just remember that when it comes to snakebite they really do suck (in a bad way). Share this post with someone else and pass on the word that devices like the Sawyer Extractor are more likely to cost you your life or limb than to save it, because folks who are making them have thus far been unwilling to stop making claims about these devices that have been repeatedly debunked by researchers.Stay safe and enjoy the great outdoors.Jordan